Sharing some of what I talk about, and learn, in my private therapy sessions. I am blessed with a wonderfully supportive psychiatrist who provides me with both medication advice and therapy. I am hoping my experiences in my sessions can help someone else.

Sunday, April 13, 2008

Co-Blogging Re-visited and a Therapeutic Epiphany

I had such an incredible therapy session on Friday. I feel like I am really making huge steps forward recently. What was so great about my session?

First, I felt so unbelievably supported during the session, something that I often feel, but, when I am severely depressed, I have a difficult time maintaining the feeling when I leave Dr. X's office. Suspicion begins sneaking into me that the support isn't 100% genuine, or real, or I heard wrong, or it is based on some kind of sneaky way to get me to change. Of course, none of that has to do with anything my pdoc does. It is some strange component of my depressed mood.

In my last session I felt able to ask really direct questions about how supportive Dr. X was of my understanding of my treatment plan. I asked him all the questions that fill my mind with guilt and despair about my understanding of what it means to work and to be well enough to work.

He so clearly supported all aspects of my understanding of our recovery plan, that I feel so much more at ease about my being on the right path now. I feel like I AM working, I AM doing what is not only best for me, but what is best for the people I volunteer to help, and for society in general. I feel like what I am doing now is the ethical thing to do.

Wow! The session was a huge relief for me. It probably helps that I feel less depressed right now and am able to absorb the lesson.

About a co-blog...I discussed it with Dr. X. He seemed to think it was an interesting idea. I sensed some trepidation on his part, but he said we could try it. One thing he mentioned was that he would not be able to read the blog throughout the week, which I had already addressed in my proposal. I also believe boundaries need to be really clear between the two of us. I told him to think about it until next session and we can discuss it again. I have been busy trying to test how private and secure a co-blog can be. It seems like you can make them so only the two of us can view and write in it. I am still checking that out.

I do have a few more concerns about a co-blog than I did before. The worry was brought on by a post I read on a blog called Jung at Heart". In her post titled, "Therapeutic Space Revisited" , Jungian Therapist Cheryl Fuller comments about the idea of writing in therapy as opposed to face to face communication. Here is an excerpt from that post:

"For the purists, a letter from a patient between sessions is an instance of acting out and they would not read it but rather place it on the table and wait for the patient to talk about it. And it is acting out, because it is an extra-therapeutic contact, a kind of effort to gain more time and attention from the therapist outside of the boundaries of their time together, and it is writing rather than putting the feelings into words and speaking them in the session. But that it is acting out does not mean it is useless, meaningless or bad; what it does is signal the presence of unresolved feelings or or need."[I find this interesting, because I have in the past sent Dr. X. cards, and it makes me think of why I do that]"The actual words of the letter may indeed impart thoughts or ideas not expressed in session but it is what drives the desire to write them rather than say them that is probably of greater importance. And dealing with the fear/resistance to expressing those feelings and thoughts directly is a big part of what depth psychotherapy is about."[(my bold)...I have wondered about this in the past...this reinforces that wonder...?]So back to the idea of co-blogging --I have to wonder if, like writing a letter or sharing a journal, this isn't at base a way to sidestep the heart of the matter -- that it takes time and effort to work through our defenses and resistances and to do so in the presence of another human being". (Cheryl Fuller, Jung At Heart")

Ms. Fuller really got me thinking about why I want to write, as opposed to talk. I have mentioned some things in my previous posts: My difficulty thinking clearly as I am often intensely emotional in my sessions...it is like my brain shuts down, I find it easier to express myself clearly when I write, Sometimes the medications that I take make it difficult for me to find the right words to describe what I am feeling...in writing I can think for the correct phrase or word, and most important, Usually I am writing in my blog to clarify to myself what happened during my session and how I could use what happened to make my next session better, more open, more honest...a sort of practice session for my next session.

Ms. Fuller is right in many ways though. There are some things I probably should be able to express in my sessions that I am unable to. For example if there is conflict in my session (honestly, by conflict I mean me misunderstanding something) I have a really hard time addressing that in the moment. When I have it has been really helpful. Usually I write about it and try to figure out how to address it the next session.

Also, if I am feeling intensely suicidal, I am afraid to address this in my session for fear I will not be able to make my own decision about what to do about it. I am afraid my freedom to choose will be taken away. So often I do not say anything, until the next session when the intensity of the feelings have dissipated.

Anyways, "Jung at Heart" gave me things to think about and I found her comments very interesting. I will address some of these ideas in my next therapy session.

I disagree a bit with what Ms Fuller says...as someone who writes a lot more than I verbalise. I have always written things better than I can say them, especially when I am depressed. With my tdoc, half of what we talked about for 3 years was what I'd written during the week, until I'd forced myself to stop doing the writing. From a patient POV tho', I'm not trying to cross boundaries with emails etc. I don't want or expect any response until the next session. Sometimes issues are raised that I just can't respond to at the time even when I know what I'd like to say. Not often, not regularly, but every now and again I will send an email to try and communicate things that I am just not going to say aloud.

With pdoc, I also send occasional links to music or scientific articles that I know he'd like - and he'll respond sometimes with other suggestions.

It worries me a bit that this could be seen as crossing boundaries, or trying to, when it really isn't intended to.

About Me

I am currently a lost soul on its quest for freedom. I have a mental illness; Chronic Major Depressive Disorder. My version of MDD sits somewhere in the Bipolar Spectrum, meaning my mood cycles between severe depression and then up high, very high, but not high enough to be considered hypomania. I am hoping to help myself and others who read this blog both understand this illness better and to learn something about ourselves in the process.